Objective: Operative intervention is a common method for the treatment of lumbar disc herniation, lumbar stenosis, lumbar fracture, and lumbar spondylolisthesis. However, with the increase of lumbar surgery, the complication rate increases accordingly. While the Physiological and Operative Severity Score for the enumeration of Mortality and Morbidity (POSSUM) scoring system has been widely used to predict morbidity in some surgical fields, the application of this system in lumbar surgery has not been reported.
Materials and Methods: From January 2008 to January 2010, we studied 158 patients (85 males and 73 females) who had operation for lumbar disc herniation, lumbar stenosis, lumbar fracture, or lumbar spondylolisthesis. All the patients were analyzed to compare the morbidity by a modified POSSUM scoring system.
Results: According to the modified POSSUM, the expected morbidity was 51 cases (32.3%) while the observed morbidity was 42 cases (26.6%). The overall observed to expected ratio was 0.82, and the Chi-squared test indicated no statistically significant difference between the expected and observed morbidities (χ2 = 1.23, P = 0.27), suggesting that the modified POSSUM can accurately estimate the outcome.
Conclusion: The modified POSSUM scoring system is a useful tool for predicting and evaluating morbidity in lumbar surgery. It provides a fairer system of comparison and would also allow an unbiased interpretation of results, if complications are clearly defined.